| Brawley Dental Clinic | |
|
1166 K St Brawley CA 92227-2737 | |
| (760) 344-3583 | |
| (760) 344-8480 |
| Full Name | Brawley Dental Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1166 K St, Brawley, California |
| Authorized Official Name and Position | Yvonne Bell (CEO) |
| Authorized Official Contact | 7603449951 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brawley Dental Clinic 852 E Danenberg Dr El Centro CA 92243 Ph: (760) 344-9951 | Brawley Dental Clinic 1166 K St Brawley CA 92227-2737 Ph: (760) 344-3583 |
| NPI Number | 1699859421 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 02/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699859421 | NPI | - | NPPES |
| 090000670 | Other | CA | DHS LICENSE |
| FHC70977F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 090000670 (California) | Primary |
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